Total joint arthroplasty (TJA) continues to be one of the most successful surgical interventions in medicine. Demand is growing rapidly, placing an increasingly heavy cost burden on national health systems. Despite the popularity of these surgeries, high-quality cost-effectiveness studies evaluating TJA are few in number. This article summarizes the current literature on value in arthroplasty, identifying the various factors affecting costs and outcomes, and suggesting how policy makers can influence utilization of TJA to further improve value to society.